23D2057948 CLIA NUMBER - MCLAREN CENTRAL MICHIGAN - TAMARA MOUTSATSON, DO, FACOI

Laboratory Demographics

  • CLIA Code: 23D2057948
  • Facility Name: MCLAREN CENTRAL MICHIGAN - TAMARA MOUTSATSON, DO, FACOI
  • Facility Address: 2853 HEALTH PARKWAY SUITE A
    MOUNT PLEASANT, MI
    ZIP 48858
  • Facility Phone: 989 779-5222
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: TAMARA MOUTSATSON
  • NPI Number: 1487274940
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D2057948
LAB Type Rural Health Clinic
Facility Name MCLAREN CENTRAL MICHIGAN - TAMARA MOUTSATSON, DO, FACOI
Street 2853 HEALTH PARKWAY SUITE A
City MOUNT PLEASANT
State MI
ZIP 48858
Phone 989 779-5222
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/26/2025
Certificate Expiration Date 4/25/2027
Facility Type Rural Health Clinic
Lab Director TAMARA MOUTSATSON

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This page was last updated on: 9/29/2025